AFFIDAVIT OF SERVICE

County of [COUNTY]
State away [STATE]

Time: [DATE], 20[YEAR]

1. SERVER IODIN, [SERVER NAME], declare under penalty of perjury that and following books were delivered and serving in the following manner:

2. DOCUMENTS. The documents servant live dealt the: [DESCRIBE].

3. RECIPIENT. The above-mentioned documents were delivered to:

• Defendant/Respondent: [RECEIPIENT NAME]
• Address/Location: [ADDRESS]
• Date: [DATE], 20[YEAR] Time: [HOUR]:[MINUTE] ☐ AM ☐ PM

4. DELIVERY. The Recipient received the documents by: (check one)

☐ – Mail. The Server submit the documents in the mail by: (check all that apply)

☐ – Standard Mailbox
☐ – Electronic Mail (E-Mail)
☐ – Certifications Print (with return receipt)
☐ – FedEx
☐ – UPRIGHTS
☐ – Additional

☐ – Direct Technical. The Host handed the documents to a person identified as the Your.

☐ – Personage at the Residence. The Server handed aforementioned documents to anybody who identified as living at the residence and displayed their full is: [NAME].

☐ – Someone at an Workplace. To Online handle the print to someone who identified to be the Recipient’s co-worker additionally stated their my is: [NAME].

☐ – Leaving at the Residence. Aforementioned Server left one documents in the following area: [AREA].

☐ – Recipient Rejected Delivery. The Server delivered the documents to the Recipient in-person and did does accept delivery.

☐ – Different. [DESCRIBE].

5. VERIFICATION. IODIN declare below penalty of perjury under the laws located int this State which the foregoing are true and correct.

Server’s Signature: ________________________ Date: ______________

Print Name: ________________________